Sleep Apnea: CPAP Treatment and Golf Performance Interview with:

Marc L. Benton, MD, FCCP, FAASM
Morristown Medical Center and Atlantic Sleep & Pulmonary Associates,
300 Madison Ave. Third Floor
Madison, NJ 07940 What are the main findings of the study?

Dr. Benton:  When compared to a group of matched controls, 12 male golfers who had moderate-severe obstructive sleep apnea syndrome (OSAS) demonstrated statistically significant improvement in their ability to play golf (as measured by changes in the Handicap Index, the standardized indicator of golfing performance) after undergoing CPAP treatment for their condition.  Treatment adherence among the group placed on CPAP was unusually high. Were any of the findings unexpected?

Dr. Benton:  The degree of improvement was most substantial in the better (and usually older) golfers. We originally expected to see the largest improvement among those who were younger with the highest handicaps (and therefore the most room for improvement).  In retrospect, however, the better golfers have done a better job of managing the technical and mechanical aspects of golf, and with the cognitive enhancement afforded by successful treatment of their OSAS, they saw measurable improvement early and more significantly than those who were less-skilled.  Additionally, we did not expect that the golfers whom we enrolled with OSAS to be essentially fully compliant with their CPAP.  Improvement in golf performance appeared to be a strong motivator for our treatment group, many of whom had already failed attempts to use CPAP and in a few cases to even get them to undergo diagnostic sleep studies. What should clinicians and patients take away from your report?

Dr. Benton:  Improvement in a number of medical conditions has been well-documented when CPAP has been successfully offered to selected patients.  Similarly, reduced accident rates are noted in commercial drivers with OSAS once treatment has been provided.  Improvement in isolated psychometric performance tests also occurs in treated sleep apnea.  Golf is a commonly-played sport that incorporates many levels of integrated cognitive and physical functions.  If CPAP treatment of OSAS results in measurable improvement in the ability of golfers to perform, it is possible that golf can be seen as a surrogate for other forms of activity where we cannot accurately measure performance improvement – such as our jobs and our day-to-day activities in our social and family environments.  Making this connection might help motivate selected patients to seek and/or be compliant with treatment who might otherwise not be interested  (especially given the mediocre levels of treatment adherence commonly observed in the treatment of OSAS).  Furthermore, the concept that mainstream and beneficial medical therapy (not just for OSAS) can secondarily improve performance in golf and possibly other sports/recreational activities further expands the opportunities for healthcare providers to be successful in our efforts to engage our patients in efforts to improve their health proactively. What recommendations do you have for future research as a result of this study?

Dr. Benton:  A study similar to this pilot needs to be done with more participants and better-defined control groups to more clearly define the impact that treating sleep apnea has on golf performance.  My expectations, based on a number of factors, is that the impact of treatment is underestimated in this study.  It would then be interesting to design future studies to look at the treatment of OSAS and possibly other common medical conditions (asthma probably being the easiest one) and the impact on other sports, activities, and behaviors where performance can be assessed.


Treatment of Obstructive Sleep Apnea Syndrome with Nasal Positive Airway Pressure Improves Golf Performance.
The Journal of Clinical Sleep Medicine
Marc L. Benton, MD, FCCP, FAASM; Neil S. Friedman, RN, RPSGT
Accepted: 9/9/2013



Last Updated on September 21, 2013 by Marie Benz MD FAAD